What If I’d Known Then What I Know Now? Re-Evaluating Diagnostic Test Meta-Analyses With New Statistical Models
Mei Chung, Tufts-New England Medical Center
Joseph Lau, Tufts-New England Medical Center
Gowri Raman, Tufts-New England Medical Center
*Christopher H Schmid, Tufts-New England Medical Center
Thomas Trikalinos, Tufts-New England Medical Center
Keywords: Diagnostic test; meta-analysis
We applied a wide array of statistical models to re-examine the conclusions from 23 meta-analyses of diagnostic tests selected randomly from all identified from a Medline search through 2003. After re-abstracting data, we identified several reasons why conclusions changed: incorrect abstraction, improper choice of unit of analysis, use of outdated and simplistic statistical models and inadequate use of meta-regression. We describe the effect of these revised conclusions on health policy and suggest strategies to improve performance of diagnostic tests.